City Research Online

Abstract

This study addresses the optimal recruitment of temporary and permanent skilled healthcare workers over a multi-interval planning horizon. Temporary workers provide flexibility but are typically more expensive, especially in healthcare settings characterized by uncertain demand and shortages of specialized staff. We develop two Markov decision process frameworks to determine the optimal blend of permanent and temporary workers while accounting for differences in recruitment timing, contract duration, available demand information, and recruitment reliability. The first framework applies to settings in which short-term demand is observed before staffing decisions are made and permanent recruitment is reliable. The second framework applies to settings in which permanent positions must be advertised before demand is known and the realized number of hires may fall short of the number advertised. For both frameworks, we prove that the optimal permanent recruitment policy has a state-dependent hire-up-to structure. For the first framework, we characterize the optimal recruitment decisions under certain conditions and show that mandatory caps on temporary staffing costs can increase total costs. For the second framework, we quantify the value of staged decision-making and show how it depends on demand-rate uncertainty and labour-market tightness. A data-informed case study of a geriatric department shows that demand-rate uncertainty is the main driver of the value of the staged framework.

Publication Type:	Article
Additional Information:	© 2026. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Subjects:	H Social Sciences > HD Industries. Land use. Labor H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management R Medicine
Departments:	Bayes Business School Bayes Business School > Faculty of Management
SWORD Depositor:	Symplectic Administrator

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